Private Rehab Practice Fights Back

$500 of $50,000 goal

Raised by 1 person in 25 months
I am requesting funds to help support Quality Care and to fight against Hospital Take Over's of Private Rehab practices.    This is an endeavor to save Quality Care and provide physical therapy services the way it should be provided.   Hospitals request and receive donations all of the time, however, these days this enable them to open up medical and/or rehab facilities which ends up putting many private practices out of business. 

In 2008 my wife and I purchased a private physical therapy practice.  I was motivated to buy the practice because even back then I didn't like what I was seeing in the world of Physical Therapy.   Big Corporations were taking over practices and physicians owned their own and in my over 25 years of experience, policy was not conducive to optimal care.    I was never an entrepreneur by nature, but in order to stay in the field I love, I had to make a choice which would allow me to continue in my field without compromising my ethics.   Therefore, I purchased a physical therapy practice in N. Cape May, NJ.  

Quality care won  the day, I was successful; found a home near my office and moved there and I've been around every since.  However, perhaps you've noticed changes in healthcare have forced physicians throughout the country to sell their practices to Hospitals and/or Big Conglomerates.   It has become too costly for many physicians to remain in independent practice.  Additionally, many privately owned physical therapy practices have gone out of business all because of the direction this country has taken in allowing a monopoly-like environment to prevail. Privately owned medical and rehabilitation centers can save us money and, more importantly, improve quality care.

As Gottlieb notes in a recent article on forbes.com, throughout the country, big conglomerates and hospitals are acting to consolidate local physicians to secure monopoly-like positions that give them bargaining power and allowing them to increase their medical and rehabilitation reimbursements. According to Gottlieb's report on Forbes.com, studies show that this sort of market concentration leads to higher healthcare costs.

In 2006, the Synthesis Project published a research synthesis on the impact of hospital consolidation of medical services on prices, costs and quality of care. Since that time, the literature has greatly expanded. The evidence and expanded evidence on competition and quality shows that competition leads to higher quality. Review of the research shows that decreasing competition via consolidating medical services will not lead to cost reductions or clinical improvement, and may lead to enhanced market power for providers. Unfortunately we are headed more toward a monopoly-like system rather than a system which fosters competition.

ObamaCare increases the costs that a physician faces by continuing to run his/her own independent medical practice in many ways, and it also creates a reimbursement scheme that favors the hospitals still further, by allowing outpatient procedures to be better compensated when they are performed inside a hospital owned practice versus an independent office.

All of these elements have had the predictable effect of driving consolidation of medical practices around the hospitals. According to Forbes.com, this is going to raise healthcare costs, and lower productivity across the medical marketplace. As the Synthesis Project of the Robert Wood Johnson Foundation concluded, ultimately, increases in health care costs are passed on to health care consumers in the form of higher premiums, lower benefits and lower wages.

As most of the physicians in my region have been bought out by Hospitals, the Hospitals have been able to obtain all of the contact information of the respective physician's patients.  The physician is certainly beholden to their employer to supply them with their patient's.  The problem is that reimbursement provided to medical and rehab services provided by a Hospital are astronomically higher than that of private practice.  Each session costs a lot more to the system which means Premiums have no choice but to skyrocket.  Question: Is it a violation of the Hippocratic Oath for a physician to send a patient to a medical or rehab facility owned by their employers when they have the option to send the patient to a facility who offers the same care, or possibly even better care and with more time availed to their respective patients at a lower cost? I’ll let the medical and rehab consumer decide for him/herself.

Note that in most states those who suffer from musculoskeletal pain can see a physical therapist directly. There is often no need to see a medical doctor first.  The Doctor of Physical Therapy can determine the need to acquire assistance from the rest of the medical team as deemed necessary.    Thus far my office has been able to weather the storm, but it's getting tougher everyday.  Hospitals have lots of money and they have a build in referral network, whereas private practices are reimbursed less and have to spend more of their own money to market to the public.   It's getting very expensive to keep a foot hold on the market, even while providing the best care possible. 

Another thing that is going on involved Big Corporate Rehab company's who make deals with Physician groups.  For example, a Rehab Corp will provide physical therapists to the Physician group so the Physicians can bill for physical therapy.  In exchange, they provide a 'Management Fee' to the Rehab Corp.  If a patient doesn't live near the Physicians office and their rehab center, the Physician has incentive to refer to their partners at another location.  Therefore, the private practices, the one's who have the time to provide the Highest Quality Care possible are bypassed. 

In my office we avail ‘No Session Time Limits’;  we allow return visits the same day without extra session charges.  We  truly care about the rehab potential of  patients and are answering only to patients.  Big Conglomerates and Hospitals are answerable to the business people.  If I want a special piece of equipment for my patients I order it; others have to jump through hoops to even hope to gain approval.  Often time spent with patients is limited to keep the process moving.  If there are billing issues, we handle them for patients immediately and with great satisfaction; whereas many Big Corps have their offices far away and those who deal with you on the phone don't know who you are  nor do they necessarily care. 

My wife recently gave birth to our 2nd daughter.  We had our daughter in a Hospital.  The Hospital actually did a Great Job and I would recommend them for anyone who is preparing to have a child.  However, soon after getting home, we received a letter from the Hospital requesting a donation.  This very Hospital owned the physicians group under my office and they moved down the street from me and they have their very own physical therapy center.    So here I am being asked for a donation which to me is asking me to donate in order to help them put me out of business.    

Hospitals have a long tradition of asking for donations, but the donations were usually for things that can only be Hospital based.  Now maybe that is where the money goes (e.g., brain injury unite, Intensive care units, etc.. etc.. etc..).  The problem is, donations free them up to help them put other people out of business apparently.   So I figured, if Hospitals can be reimbursed more than I can even if I provide longer services and better services, if they can buy out physicians and buy out many of my referral sources, if they can request donations which ultimately help them put me out of business, then I believe I can also ask for donations to help preserve Quality Care and competition.    The more people who go to private practices, physician and/or rehab specialists / Doctors of Physical Therapy, the more competition Hospitals and Big Conglomerates have, the more likely it will be for costs to come down and Quality to improve.  

I'm still running a practice that doesn't do so badly considering today's healthcare environment; however things are changing and it's getting tough to compete with those whom have such an advantage over us.  Therefore I'm seeking help to build my practice and to let people know they don't have to settle for Hospital based expensive therapy.  

The money I would acquire from this endeavor would go to the practice.   Marketing and advertising is crucial. The public has to be informed that they have a Right To Choose Where They Go for their Physical Therapy services and that where their doctors send them may be influenced by their employment positon and/or monetary gain.    It use to be illegal for physicians to own physical therapy practices, look what's going on now.  The money would also go to other items as deemed necessary for the business, such as equipment, larger space and reasonable employee salaries. 

My patients stay in my facility on average 2 hours; many 3 and even more hours depending upon their motivation and potential benefit.  I don't force them to stay longer, I just avail the time to them.  This is how care should be delivered and this money would enable me to not only keep my practice, but to expand and educate the public as to how to acquire quality care without helping to break the healthcare bank by utilizing expensive Hospital services which are unnecessary.   Whether I acquire these funds or not, I'm going to continue to Fight to not only survive but to thrive and if you feel dispensing quality care is important, if you believe healthcare should not cost more when provided by Hospitals and/or Big Conglomerates, then please help me make a huge statement about the importance of independent practice.   

Once our financial goals are achieved, you can follow our progress and see what we've done with the funds.  See new equipment, possibly a larger location that also provides medical fitness and an ability to provide care to those who cannot afford it.  Helping those who are uninsured and/or underinsured is also a goal of our.  Your support would be greatly appreciated by, not only us, but patients who will benefit from the services provided.  My thanks in advance for your support.  Even if I don't reach my financial goal, any amount would be helpful.  I have patient's in mind and the preservation of cost-effective rehab care.  Thank you so much for your consideration.
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$500 of $50,000 goal

Raised by 1 person in 25 months
Created November 1, 2016
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25 months ago
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